Who can administer
  
                  May be administered by registered competent doctor or nurse/midwife
      
  
        Important information
  
                  
- See monitoring requirements
 
- Consider intravenous to oral switch as soon as possible as excellent oral bioavailability (approx.100%) - use same dose orally as intravenously
 
- Red-light antimicrobial: requires pre-authorisation by Microbiology or ID prior to use 24 hours / 7 days a week
 
- There are numerous important interactions - check current BNF (and also see under 'Monitoring')
 
      
  
        Available preparations
  
                  Linezolid 600mg per 300ml solution for infusion
      
  
        Reconstitution
  
                  Already in solution
      
  
        Infusion fluids
  
                  Not required - product ready for infusion
      
  
        Methods of intravenous administration
  
                  Intermittent intravenous infusion
- Administer over 30 to 120 minutes
 
      
  
        Dose in adults
  
                  Usual dose
- Give 600mg every twelve hours
 
- Duration of treatment: usually 10 to 14 days
 
Renal impairment
- eGFR less than 30ml/minute/1.73m2 - no dose adjustment required but use with caution as metabolites may accumulate
 
- Monitor FBC closely if eGFR <10ml/minute/1.73m2(ref 1)
 
- If being used in patients on haemodialysis- should be given after dialysis session
 
Hepatic impairment
- No dose adjustment is required. However, there are limited clinical data and it is recommended that linezolid should be used in such patients only when the anticipated benefit is considered to outweigh the theoretical risk
 
      
  
        Monitoring
  
                  
- Monitor FBC (including haemoglobin, platelets, and total and differential leucocyte counts) weekly in all patients (risk of haematopoeitic disorders)
 
- Monitor blood pressure closely in uncontrolled hypertension, phaeochromocytoma, carcinoid, thyrotoxicosis, bipolar depression, schizoaffective disorder, acute confusional state or in patients taking SSRIs, tricyclic antidepressants, triptans, sympathomimetic agents, vasopressive agents, dopaminergic agents, pethidine or buspirone
 
- Monitor for signs and symptoms of serotonin syndrome if used with serotonergic agents
 
- Monitor for signs of metabolic acidosis
 
- Contains 13.7g glucose per 300mL injection solution
 
      
  
        Further information
  
                  
- Linezolid should not be used in patients taking any drug which inhibits Monoamine oxidases A or B (e.g. phenelzine, selegiline, moclobemide, isocarboxazid) or within two weeks of having taken such drugs
 
- The safety and efficacy of linezolid when administered for periods longer than 28 days have not been established. Severe peripheral or optic neuropathy may occur rarely, especially if linezolid is used for longer than 28 days
 
- High-tech prescription needed if patient being discharged on oral form
 
      
  
        Storage
  
                  Store below 250C
      
  
        References
  
                  Fresesius Kabi SPC September 2024
Krka SPC July 2023
(1) Antimicrobial Guidelines for GUH
      
  
        Therapeutic classification
  
                  Oxazolidinone antimicrobial